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General NPI Number Information
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NPI Number | 1356723159
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Entity Type | Individual
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Provider Name | ASHLEY MONIQUE PALMER NP-C
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Gender | Female
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Dates
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Enumeration Date | 06/29/2015
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Last Update Date | 03/15/2016
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Provider Practice Location Address
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Address Line | 4692 BROWNSBORO RD
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City | WINSTON SALEM
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State | NC
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Zip | 27106-3410
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Country | US
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Telephone | 336-251-1114
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Fax |
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Provider Business Mailing Address
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Address Line | 8520 PROSSER WAY APT 106
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City | CHARLOTTE
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State | NC
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Zip | 28216-1019
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5008108
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License Number State | NC
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